Question

PART 1 Case Information: You are a public health officer on a population Pacific island. You receive a call on October 5 from an occupational physician who describes an outbreak of unusual illness that began during the last week of September among workers at a printing factory. The physician tells you that a number of workers became ill within a 2 to 3-day period. Their symptoms included double vision, drooping eyelids, muscle weakness, and progressive respiratory weakness. Two workers have been hospitalized and require mechanical ventilation to assist in breathing. Table 1 Steps in an Outbreak Investigation Initial phase 1. 2. 3. Gather information on index case(s) Determine likelihood that epidemic exists Verify the diagnosis of reported cases Descriptive Phase 1. 3 Establish case definition, including person, time, and place Develop possible etiologic hypotheses, considering potential exposures Define population at risk (include parameters of time and place) Look for additional cases: establish surveillance Measure excess disease occurrence Analytic Phase 1. Develop specific hypotheses Choose proper study design Plan, execute and analyse study (including investigation of source with assistance of laboratory) IV Control Phase 1. Institute control preventive measures References: a) Investigating Environmental Disease Outbreaks, Training Manual WHO/PEP. 1991 b) Centres for Disease Control. Guidelines for Investigating Clusters of Health Events. MMWR, 39: (RR-11). 1990 Question 1: Based on Table 1, please list at least two questions that you could ask the doctor to determine if this is an outbreak, to gather information on index cases, or to verify the diagnosis of the reported cases. (4 points)

Answer 1

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Questions that you could ask the doctor to determine if this is outbreak

1. Is the disease contagious?

2.What is the daignosis of the of the symptoms?

3. What is the number of cases recorded?

4. What is the cause of the symptoms?

To gather information on the cases the health professional should ask following Questions:

1. Did you use any new chemical in the printing industry?

2. After contact with a particular chemical that was been used , when did the symptoms started?

Identify the existence of the outbreak

Verify the diagnosis related to the outbreak

Create a case definition to define who/what is included as a case

Map the spread of the outbreak using Information technology as diagnosis is reported to insurance

Develop a hypothesis (What appears to be causing the outbreak?)

Study hypotheses (collect data and perform analysis)

Refine hypothesis and carry out further study

Develop and implement control and prevention systems

Release findings to greater communities

• clinical information about the disease,
• characteristics of the people who are affected,
• information about the location or place, and
• Specification of the time during which the outbreak occurred.